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Routes of administration: Difference between revisions
>David Hedlund →Transdermal: m |
>David Hedlund Non-oral administration methods circumvent the gastrointestinal tract's breakdown of certain compounds like DMT, which would otherwise necessitate the use of monoamine oxidase inhibitors (MAOIs), referred to as pharmahuasca or ayahuasca when the MAOI and DMT originate from plant extracts, if ingested orally. However, combining MAOIs with many psychoactive substances or tyramine-rich foods can be extremely dangerous. |
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===Oral=== | ===Oral=== | ||
Oral administration is the most common route of administration for most substance classes. This route allows a substance to be absorbed through blood vessels lining the stomach and intestines. The onset is generally slower than other methods of ingestion as it must undergo first-pass metabolism through the liver (may vary greatly between individual substances).<ref name="Ohlsson1980">{{cite journal | vauthors=((Ohlsson, A.)), ((Lindgren, J.-E.)), ((Wahlen, A.)), ((Agurell, S.)), ((Hollister, L. E.)), ((Gillespie, H. K.)) | journal=Clinical Pharmacology and Therapeutics | title=Plasma delta-9-tetrahydrocannabinol concentrations and clinical effects after oral and intravenous administration and smoking | volume=28 | issue=3 | pages=409–416 | date= September 1980 | url=http://doi.wiley.com/10.1038/clpt.1980.181 | issn=0009-9236 | doi=10.1038/clpt.1980.181}}</ref> Additionally, the absorption and overall duration are generally longer as well. | Oral administration is the most common route of administration for most substance classes. This route allows a substance to be absorbed through blood vessels lining the stomach and intestines. The onset is generally slower than other methods of ingestion as it must undergo first-pass metabolism through the liver (may vary greatly between individual substances).<ref name="Ohlsson1980">{{cite journal | vauthors=((Ohlsson, A.)), ((Lindgren, J.-E.)), ((Wahlen, A.)), ((Agurell, S.)), ((Hollister, L. E.)), ((Gillespie, H. K.)) | journal=Clinical Pharmacology and Therapeutics | title=Plasma delta-9-tetrahydrocannabinol concentrations and clinical effects after oral and intravenous administration and smoking | volume=28 | issue=3 | pages=409–416 | date= September 1980 | url=http://doi.wiley.com/10.1038/clpt.1980.181 | issn=0009-9236 | doi=10.1038/clpt.1980.181}}</ref> Additionally, the absorption and overall duration are generally longer as well. | ||
Non-oral administration methods circumvent the gastrointestinal tract's breakdown of certain compounds like [[DMT]], which would otherwise necessitate the use of [[monoamine oxidase inhibitor]]s (MAOIs), referred to as [[pharmahuasca]] or [[ayahuasca]] when the MAOI and DMT originate from plant extracts, if ingested orally. However, combining MAOIs with many psychoactive substances or tyramine-rich foods can be extremely dangerous. | |||
====Risks==== | ====Risks==== | ||
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To smoke a substance a direct heat source, most often a flame, is applied directly to the substance with no barrier between the heat source and the substance. The smoking of substances can lead to an almost instantaneous absorption of the substance and passage through the blood brain barrier.<ref name="Ohlsson1980" /> | To smoke a substance a direct heat source, most often a flame, is applied directly to the substance with no barrier between the heat source and the substance. The smoking of substances can lead to an almost instantaneous absorption of the substance and passage through the blood brain barrier.<ref name="Ohlsson1980" /> | ||
When a substance is smoked, the substance is absorbed through blood vessels found in the bronchi tubes contained within the lungs. Like insufflation, the duration is decreased while its intensity is increased in proportion to oral absorption | When a substance is smoked, the substance is absorbed through blood vessels found in the bronchi tubes contained within the lungs. Like insufflation, the duration is decreased while its intensity is increased in proportion to oral absorption. | ||
Cannabis is commonly consumed via the respiratory tract. The average THC transfer rate for joints, bongs, and vaporizers, is 20-26%,<ref name="ukcia">https://www.ukcia.org/research/FactorsThatInfluenceBioavailability.pdf</ref> 40%,<ref name="ukcia" /> and 55-83%,<ref>{{cite journal | vauthors=((Lanz, C.)), ((Mattsson, J.)), ((Soydaner, U.)), ((Brenneisen, R.)) | journal=PLoS ONE | title=Medicinal Cannabis: In Vitro Validation of Vaporizers for the Smoke-Free Inhalation of Cannabis | volume=11 | issue=1 | pages=e0147286 | date=19 January 2016 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718604/ | issn=1932-6203 | doi=10.1371/journal.pone.0147286}}</ref> respectively. For a proper gas or smoke deposition, one are advised to take a deep initial breath, and then hold it for 10 seconds to allow for the gas or smoke to get fully absorbed in the lungs. Subjects are frequently instructed to follow the "10 seconds rule" in studies.<ref>{{cite journal | vauthors=((Wallace, M. S.)), ((Marcotte, T. D.)), ((Umlauf, A.)), ((Gouaux, B.)), ((Atkinson, J. H.)) | journal=The journal of pain : official journal of the American Pain Society | title=Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy | volume=16 | issue=7 | pages=616–627 | date= July 2015 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152762/ | issn=1526-5900 | doi=10.1016/j.jpain.2015.03.008}}</ref><ref>{{cite journal | vauthors=((Wilsey, B.)), ((Marcotte, T.)), ((Tsodikov, A.)), ((Millman, J.)), ((Bentley, H.)), ((Gouaux, B.)), ((Fishman, S.)) | journal=The journal of pain : official journal of the American Pain Society | title=A Randomized, Placebo-Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain | volume=9 | issue=6 | pages=506–521 | date= June 2008 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968043/ | issn=1526-5900 | doi=10.1016/j.jpain.2007.12.010}}</ref> Prolonged breath holding does not substantially enhance the effects of inhaled marijuana smoke.<ref>{{cite journal | vauthors=((Zacny, J. P.)), ((Chait, L. D.)) | journal=Psychopharmacology | title=Response to marijuana as a function of potency and breathhold duration | volume=103 | issue=2 | pages=223–226 | date= 1991 | issn=0033-3158 | doi=10.1007/BF02244207}}</ref><ref>{{cite journal | vauthors=((Zacny, J. P.)), ((Chait, L. D.)) | journal=Pharmacology, Biochemistry, and Behavior | title=Breathhold duration and response to marijuana smoke | volume=33 | issue=2 | pages=481–484 | date= June 1989 | issn=0091-3057 | doi=10.1016/0091-3057(89)90534-0}}</ref> | Cannabis is commonly consumed via the respiratory tract. The average THC transfer rate for joints, bongs, and vaporizers, is 20-26%,<ref name="ukcia">https://www.ukcia.org/research/FactorsThatInfluenceBioavailability.pdf</ref> 40%,<ref name="ukcia" /> and 55-83%,<ref>{{cite journal | vauthors=((Lanz, C.)), ((Mattsson, J.)), ((Soydaner, U.)), ((Brenneisen, R.)) | journal=PLoS ONE | title=Medicinal Cannabis: In Vitro Validation of Vaporizers for the Smoke-Free Inhalation of Cannabis | volume=11 | issue=1 | pages=e0147286 | date=19 January 2016 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718604/ | issn=1932-6203 | doi=10.1371/journal.pone.0147286}}</ref> respectively. For a proper gas or smoke deposition, one are advised to take a deep initial breath, and then hold it for 10 seconds to allow for the gas or smoke to get fully absorbed in the lungs. Subjects are frequently instructed to follow the "10 seconds rule" in studies.<ref>{{cite journal | vauthors=((Wallace, M. S.)), ((Marcotte, T. D.)), ((Umlauf, A.)), ((Gouaux, B.)), ((Atkinson, J. H.)) | journal=The journal of pain : official journal of the American Pain Society | title=Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy | volume=16 | issue=7 | pages=616–627 | date= July 2015 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152762/ | issn=1526-5900 | doi=10.1016/j.jpain.2015.03.008}}</ref><ref>{{cite journal | vauthors=((Wilsey, B.)), ((Marcotte, T.)), ((Tsodikov, A.)), ((Millman, J.)), ((Bentley, H.)), ((Gouaux, B.)), ((Fishman, S.)) | journal=The journal of pain : official journal of the American Pain Society | title=A Randomized, Placebo-Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain | volume=9 | issue=6 | pages=506–521 | date= June 2008 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968043/ | issn=1526-5900 | doi=10.1016/j.jpain.2007.12.010}}</ref> Prolonged breath holding does not substantially enhance the effects of inhaled marijuana smoke.<ref>{{cite journal | vauthors=((Zacny, J. P.)), ((Chait, L. D.)) | journal=Psychopharmacology | title=Response to marijuana as a function of potency and breathhold duration | volume=103 | issue=2 | pages=223–226 | date= 1991 | issn=0033-3158 | doi=10.1007/BF02244207}}</ref><ref>{{cite journal | vauthors=((Zacny, J. P.)), ((Chait, L. D.)) | journal=Pharmacology, Biochemistry, and Behavior | title=Breathhold duration and response to marijuana smoke | volume=33 | issue=2 | pages=481–484 | date= June 1989 | issn=0091-3057 | doi=10.1016/0091-3057(89)90534-0}}</ref> | ||
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Even though many drugs, like [[heroin]] and [[oxycodone]] pills are colloquially referred to as "smoked" the process used to consume them is vaporization. Vaporizing substances can lead to an almost instantaneous absorption of the substance and passage through the blood brain barrier.<ref name="Ohlsson1980" /> | Even though many drugs, like [[heroin]] and [[oxycodone]] pills are colloquially referred to as "smoked" the process used to consume them is vaporization. Vaporizing substances can lead to an almost instantaneous absorption of the substance and passage through the blood brain barrier.<ref name="Ohlsson1980" /> | ||
When a substance is vaporized, the substance is absorbed through blood vessels found in the bronchi tubes contained within the lungs. Like insufflation, the duration is decreased while its intensity is increased in proportion to oral absorption | When a substance is vaporized, the substance is absorbed through blood vessels found in the bronchi tubes contained within the lungs. Like insufflation, the duration is decreased while its intensity is increased in proportion to oral absorption. | ||
Vaporization is commonly associated with the vaporizer pens that have become popular within the past decade, but it is not limited to ingesting the vapors from an electronic heat source. | Vaporization is commonly associated with the vaporizer pens that have become popular within the past decade, but it is not limited to ingesting the vapors from an electronic heat source. | ||
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About 0.1 mL of the solution is lost in conventional syringes through the [https://en.wikipedia.org/wiki/Luer_taper Luer taper] tip and the Luer taper adapter of the hypodermic needle. That can be compensated by either adding extra 10% or 5% substance in 1 mL or 2 mL syringes respectively, or by using [https://en.wikipedia.org/wiki/Low_dead_space_syringe low dead space syringes].<!-- Added to: Routes of administration, Safer injection guide --> | About 0.1 mL of the solution is lost in conventional syringes through the [https://en.wikipedia.org/wiki/Luer_taper Luer taper] tip and the Luer taper adapter of the hypodermic needle. That can be compensated by either adding extra 10% or 5% substance in 1 mL or 2 mL syringes respectively, or by using [https://en.wikipedia.org/wiki/Low_dead_space_syringe low dead space syringes].<!-- Added to: Routes of administration, Safer injection guide --> | ||
===Intravenous=== | ===Intravenous=== | ||
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Rectal administration can involve either the insertion of a low-volume solution into the rectum, using a syringe or pipette, or by placing a pill or gelatin capsule containing the active substance. The latter form is known as a suppository, and is common in medicine when the gastrointestinal tract cannot support oral medicine. | Rectal administration can involve either the insertion of a low-volume solution into the rectum, using a syringe or pipette, or by placing a pill or gelatin capsule containing the active substance. The latter form is known as a suppository, and is common in medicine when the gastrointestinal tract cannot support oral medicine. | ||
===Risks=== | ===Risks=== | ||